【摘 要】
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Hepatic encephalopathy is an often devastating complication of chronic liver disease, associated with high mortality and in-creased burden on patients and healthcare systems. Current agents (such as nonabsorbable disaccharides and oral anti-biotics) are o
【机 构】
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Department of Medicine,Division of Gastroenterology-Hepatology,University of Connecticut Health Cent
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Hepatic encephalopathy is an often devastating complication of chronic liver disease, associated with high mortality and in-creased burden on patients and healthcare systems. Current agents (such as nonabsorbable disaccharides and oral anti-biotics) are often only partially effective and associated with unpleasant side effects. With our improved understanding of the pathophysiology of hepatic encephalopathy, multiple treatment modalities have emerged with promising results when used alone or as an adjunct to standard medications. The mechanisms of these agents vary greatly, and include the manipulation of gut microbial composition, reduction of oxi-dative stress, inhibition of inflammatory mediators, protection of endothelial integrity, modulation of neurotransmitter re-lease and function, and other novel methods to reduce blood ammonia and neurotoxins. Despite their promising results, the studies assessing these treatment modalities are often limited by study design, sample size, outcome assessment heterogeneity, and paucity of data regarding their safety pro-files. In this article, we discuss these novel agents in depth and provide the best evidence supporting their use, along with a critical look at their limitations and future directions. Citation of this article: Hasan LZ, Wu GY. Novel agents in the management of hepatic encephalopathy: a review.
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